This following is Dr. Rosi’s response to the Blog The Hills and Valleys of Being the Mother of a Child with Adolescent Depression from December 10, 2015.
Thanks for sharing this story. It is wonderful to hear that your daughter has supportive parents and professionals assisting in her care. You bring up some very important points that should be highlighted.
First and foremost, identifying the symptoms of depression is essential. It is extremely challenging to separate out what is "normal" developmental behavior versus signs and symptoms of depression. It sounds like you were able to identify early her anxiety and her depression, seek professional assistance and start treatment. I will repeat the following in future posts as a point of emphasis to all parents: the longer the symptoms of depression go unidentified and untreated, the harder it will be to eliminate them with any treatment modality, whether it be medication, therapy, neuromodulation or other. The sooner treatment is initiated, the better the prognosis for the child.
To that end, finding a psychiatrist who is trained in treating children and adolescents is a major obstacle unto itself. There is a nationwide shortage of Child and Adolescent Psychiatrists, and if you find one the wait for a new appointment can be months away. This is an additional reason for identifying symptoms and seeking professional help early on. It sounds as though you have found a psychiatrist with such a background, though perhaps after some searching and trial and error.
You also mentioned your daughter had multiple medication trials before finding the correct combination. This is often more the norm than the exception since children have a lower response rate to medications compared to adults and are more vulnerable to side effects. There are very few FDA approved medications for depression in children and adolescents, and a large majority of pharmaceutical companies do not pursue such indications. Determining the right medication(s) and dosing can take a great deal of time and patience. I am pleased that your daughter has achieved this.
Lastly, treating adolescent depression truly is a "team effort." It is essential to involve parents, siblings, teachers, therapist and psychiatrists, all of whom can assist the child during the potentially difficult times. Though the term "depression" has entered into the mainstream vernacular, it is often mislabeled and misunderstood. A stigma remains around depression, especially in adolescents and the more supportive the people around the child, the more he or she will be able to discuss the symptoms and their effects. Creating an open conversation around the depression is very important. Many teens struggle with identity in adolescence, and teens with depression will often view themselves more negatively, thereby affecting their motivation for discussion and self-disclosure. Therefore, I always advocate for a team approach, involve the child in this discussion from the start, and keep an open dialogue with the family and treatment providers. It is said it takes a village to raise a child, and that village is definitely needed to help the depressed child through what can be the biggest challenge they have faced.
Since graduating from a Child & Adolescent Psychiatry Fellowship at Stanford University in 2007, Dr. Kevin Rosi has focused primarily on treating mood and anxiety disorders in children, adolescents and young adults. He is Board Certified in Adult Psychiatry by the American Board of Neurology and Psychiatry, and completed a visiting fellowship in Transcranial Magnetic Stimulation at Duke University in 2015.
Dr. Rosi’s areas of expertise include early onset Bipolar Disorder, ADHD, and eating and developmental disorders. He also has extensive experience in dealing with behavioral disorders, such as Oppositional Defiant Disorder, as well as impulse control and psychotic disorders.
Dr. Rosi believes in building a trusting working relationship with his patients thorough open communication, and in educating them about all available modalities so treatment decisions can be made collaboratively.
Using a holistic approach that emphasizes pharmacologic and non-pharmacologic treatments, such as psychotherapy, neuromodulation and developing healthy living habits, Dr. Rosi works together with his patients toward the goals of symptom elimination and restoring health.
Dr. Rosi joined TMS Health Solutions in 2015 after serving over eight years in a community mental health outpatient clinic and maintaining a private practice in Davis, California.